Putting New Strategies in Place to Decrease Workplace Violence



By Megan Headley

Incidences of workplace violence remain too high for the healthcare industry, despite increased attention on this issue. Bureau of Labor Statistics data indicates that from 2002 to 2013 incidents of serious workplace violence were, on average, four times more common in healthcare than in private industry. In fact, data indicates that healthcare accounts for nearly as many serious violent injuries as all other industries combined.

“Too many healthcare workers face threats and physical violence on the job while caring for our loved ones,” commented the current assistant secretary of labor for occupational safety and health, Dr. David Michaels, in a December 2015 news release on this topic. “It is not right that these valuable workers continue to be injured and sometimes killed on the job. Most of these injuries are preventable and the Occupational Safety and Health Administration (OSHA) is providing … resources to help combat these incidents and raise awareness that violence does not need to be part of the job.”

Among those resources is a website OSHA launched to provide healthcare employers and workers with strategies and tools they can put to use in preventing workplace violence. The new Web page is part of OSHA’s Worker Safety in Hospitals website and is intended to complement its updated Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers that was published earlier this year.

The Worker Safety in Hospitals website addresses the problem of violence in healthcare facilities by providing hospital administrators with information on the risk factors, associated costs and actions that can be taken to manage the problem. Among other solutions, the webpage includes several real-life examples of healthcare organizations that have incorporated successful workplace violence prevention programs, as well as models of how a workplace violence prevention program can complement and enhance an organization’s strategies for compliance and help create a culture of safety.

Creating a Safer Environment

Jeff Young, CPP, CHPA, executive director of Lower Mainland Integrated Protection Services and president of the International Association for Healthcare Security and Safety (IAHSS), notes that the OSHA resource is great for healthcare facility managers and security directors looking for additional guidance in this area.

“This is top of mind for our membership, many of whom not only lead site-based security first-responders, but also either lead or play a significant stakeholder role in developing a comprehensive multidiscipline violence prevention program for their healthcare organizations,” he says.

Young finds that the challenge for security directors looking to improve their facilities’ safety is that the issue of mitigating workplace violence is such a complex, multifaceted issue. “A security director at a hospital will look at everything from the physical environment design in terms of safeguarding the environment … to staff training and recognition,” he says.

Young points to the IAHSS Design Guidelines as a crucial resource for improving the physical environment. But in terms of staff training, he finds that the biggest resource can come from a well-integrated team approach.

“There are a multitude of programs out there, but I think the best programs are those that are multifaceted and include a multidiscipline team approach,” Young says.

Building Staff Awareness

In his experience in the security arena, Young finds that the vast majority of cases of aggression come from patients with mental health or addiction issues. As a result of this, he says, it’s important to address this as a clinical issue, “where aggression may be in many cases a symptom of the patient’s mental health or addiction medical issues.”

He elaborates, “I think the challenge that we have as security professionals is integration with the clinical side and ensuring that it truly is a multidiscipline team approach.” Training clinicians, who are generally on the frontline when it comes to workplace violence, to respond rapidly allows security professionals to more rapidly deploy mitigation strategies and responses.

In many cases, hospitals are already finding some ways to bring security into the loop at the first indication of potential violence.

“One of the things we’ve done across the board in North America is flag patients with a history,” Young says. “The best predictor of future behavior is past behavior, so when a patient presents who has a history of aggression or violence, he or she is flagged in the computer system, so as soon as that person presents in the ER, our staff is made aware that there is a history of violence.”

It’s an effective example of integrating security with the front-line teams.

“The more we can come together as a multidiscipline team with security and clinicians, the better off we will be,” Young says.

Sutter Healthcare in California is working to improve staff awareness of this issue by shifting from online-based training to more active exercises.

“Like many groups, we’ve had online training every year. We have policies on how to report it, what to look for. And we’ve done additional training with security in terms of de-escalation and using some of the recommended tools, such as the conflict de-escalation language that IAHSS promotes,” says Jerry Glotzer, regional director for Sutter Healthcare. “Because of the events we’ve seen escalate around the country … we’ve been doing more ‘up close and personal’ training, and using the run-hide-fight suggested [protocol].”

More recently, the Sutter Health team began working with local law enforcement agencies to host live training exercises. “We have found that folks are receptive to having more of this up-close training, and even though it can be a bit anxiety-producing, if it’s done right it can be very effective,” Glotzer says.

Putting Prevention Strategies in Place

IAHSS and the Emergency Nurses Association are just two of the organizations offering helpful resources on recognizing potential workplace violence. The OSHA webpage is particularly helpful in providing steps to take to create an environment focused on eliminating workplace violence.

The new website offers five building blocks that it suggests form the core of a workplace violence prevention program. These include:

  1. Management commitment and employee participation. Managers should let employees see that workplace violence prevention is a priority, and should embrace input from employees who can help improve the program.
  2. Worksite analysis and hazard identification. This should be an ongoing process, with regular reassessments and reevaluations after any incident. 
  3. Hazard prevention and control. In addition to eliminating or controlling workplace hazards by following specific procedures, progress should be tracked to make sure these procedures are working.
  4. Safety and health training. It is important to ensure that all employees are trained to recognize hazards and understand what to do in the event of an emergency.
  5. Record keeping and program evaluation. Keeping track of injuries, incidents, hazards, etc., will help identify the severity of the problem and better evaluate effective solutions.


About the Author

Megan Headley is a contributing writer with more than a decade of experience writing about the built environment.

Editor’s Note: This article originally appeared in FacilityCare.